AMA Raises Reimbursement Concerns Over EHR Workarounds

Physicians' use of electronic health records may lead to denial of reimbursement for some services, the American Medical Association chair warned last week.

During a CMS listening session, AMA chair Steven Stack, MD, who is also a Lexington, KY emergency physician, said that some Medicare carriers have already issued rules that if patient charts look too similar, they will deny payment for them.

Stack says this is happening even when physicians are using EHR software appropriately and under threat of financial penalty if they do not use EHR software.

In essence, physicians "are being instructed de facto to reengineer non-value-added variation into their clinical notes," Stack says. "This is an appalling Catch-22 for physicians."

Between 2010 and 2012, the percentage of doctors who would not recommend their EHR to a colleague increased from 24 percent to 39 percent. Approximately one third of the 4,279 physicians surveyed said they were very dissatisfied with their EHR, and that it is becoming more difficult to return to pre-EHR levels of productivity.

"Simply stated, many EHRs are not friendly to the user, and rather than improving physician efficiency, they are a widespread source of frustration," Stack says.

Dr Bones (5/7/2013 at 5:27 PM)
Perhaps providers who work in small practices or those that are using the "free EHR"s have an inability to document a free form note but the majority of large EHR's have this capability. You can even dictate the history and physical and or the clinical notes and have it blown into the chart. It sounds like those practices that went the "cheap" way and didn't invest in any workflow redesign or pay for some consulting time are tripping up but this is the minority.